AB1020 MUSCULOSKELETAL INVOLVEMENT IN INFLAMMATORY BOWEL DISEASE PATIENTS: A MONOCENTRIC EXPERIENCE
Authors: A. Delle Sedie, L. Ceccarelli, F. Costa, F. Fattorini, C. Cigolini, M. Mosca, L. Carli
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Musculoskeletal (MSK) symptoms, varying from arthralgia to arthritis are frequently reported by patients (pts) with inflammatory bowel diseases (IBD). A peripheral or axial joint involvement has been reported with a similar range from 5 to 30% and a definite spondyloarthritis (SpA) diagnosis is present in up to 46% of patients with IBD [1-8]. To date, a more comprehensive disease control is requested and the optimization of the treatment (choosing a mono or a combination therapy strategy) to improve both gastrointestinal and musculoskeletal is mandatory. <h3>Objectives</h3> To evaluate the rate of MSK involvement in a mono centric cohort of IBD pts and the consequent need to optimize their therapeutical schemes. <h3>Methods</h3> A gastroenterologist working in the IBD out-patient clinic had selected IBD patients who should be referred to the rheumatologic visit, on the basis of the results of a questionnaire aimed at highlighting the presence of clinical features suggestive of SpA. From January 1<sup>st</sup> 2017 to December 31<sup>st</sup> 2022 IBD pts have been evaluated by a rheumatologist expert in SpA. In case of doubts about the diagnosis, further examinations were requested. The diagnosis of SpA was made following the ASAS criteria of 2011. <h3>Results</h3> A total of 288 pts were sent to the rheumatologist (140 CD, 127 UC, 21 not defined IBD). One hundred sixty-eight pts received only one rheumatological visit while, one hundred two were evaluated twice or more times. To make a diagnosis, 37 MRI (30 for sacroiliac joints), 30 ultrasound assessment (mostly hands, wrists or feet), 19 X-rays and 23 blood tests were requested. Most of pts (196/288, 68%) were not classified as SpA; 50/288 (17.4%) were peripheral SpA and 24/288 (8.3%) were axial SpA, in 18/288 (6.3%) there was an isolated entheseal involvement. The rheumatologist recommended a therapeutical optimization in 138 IBD pts (47.9%). In particular, a DMARD was added in 59 pts and a bDMARD was prescribed in 6 for rheumatological indications; moreover, in 73 cases, a choice between two different therapeutical approaches was suggested to the gastroenterologist, in order to improve the control of MSK disease activity on the basis of IBD course. <h3>Conclusion</h3> Our results confirm the already published prevalence of MSK involvement in IBD patients. A relevant number of IBD pts, after the rheumatological evaluation, were classified as peripheral (17.4%) or axial (8.3%) SpA. In about half of IBD pts, a therapeutical modification was recommended by the rheumatologist, aiming at improving the control of MSK disease activity in the context of the IBD course. These data confirm the importance of a close collaboration between gastroenterologists and rheumatologists, to optimize the clinical assessment of IBD pts, thus improving their quality of care [9]. <h3>References</h3> [1]Bandyopadhyay D et al. Indian J Gastroenterol. 2015 [2]Kamo K et al. Mod Rheumatol. 2015 [3]Leclerc-Jacob S et al. Aliment Pharmacol Ther. 2014 [4]Shivashankar R et al. J Rheumatol. 2013 [5]Stolwijk C et al. Can J Gastroenterol. 2013 [6]Beslek A et al. Rheumatol Int. 2009 [7]Palm O et al. J Rheumatol. 2002 [8]Salvarani C et al. Scand J Gastroenterol. 2001 [9]Olivieri I et al. Autoimmun Rev. 2014 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.